Neurological manifestations of patients infected with the SARS-CoV-2: a systematic review of the literature.
Neurological manifestations of patients infected with the SARS-CoV-2: a systematic review of the literature.
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DOI：
10.1007/s00415-020-10285-9
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发表时间：
2021-08
影响因子：
6
通讯作者：
Costalat V
中科院分区：
文献类型：
--
作者：
Cagnazzo F;Arquizan C;Derraz I;Dargazanli C;Lefevre PH;Riquelme C;Gaillard N;Mourand I;Gascou G;Bonafe A;Costalat V
为了对COVID-19感染患者神经系统表现的文献进行更新综述，在PubMed、EMBASE和SCOPUS上进行了基于PRISMA指南的系统综述。研究了COVID-19患者的神经系统表现的系列报告。纳入了39项研究和68，361名实验室确诊的COVID-19患者。高达21.3%的COVID-19患者出现神经系统症状。头痛（5.4%）、骨骼肌损伤（5.1%）、精神疾病（4.6%）、意识受损（2.8%）、味觉/嗅觉功能障碍（2.3%）、急性脑血管事件（1.4%）和头晕（1.3%）是最常报告的神经系统表现。1.3%的COVID-19患者发生缺血性卒中。其他不太常见的神经系统表现包括颅神经损伤（0.6%）、神经根和神经丛疾病（0.4%）、癫痫（0.7%）和出血性中风（0.15%）。意识障碍和急性脑血管事件分别在14%和4%的重症患者中报告，并且与非重症患者相比显著更高（p < 0.05）。提取了129例COVID-19急性缺血性卒中（AIS）患者的个体患者数据：平均年龄为64.4（SD ± 6.2），78.5%患有前循环闭塞，平均NIHSS为15（SD ± 7），院内死亡率为22.8%。63%的患者需要入住重症监护室（ICU）。这篇更新的文献综述显示，头痛、骨骼肌损伤、精神疾病、意识受损和味觉/嗅觉功能障碍是COVID-19患者最常见的神经系统症状。意识障碍和急性脑血管事件在严重感染的患者中明显更高。63%的AIS患者需要入住ICU，而院内死亡率接近23%。本文的在线版本（10.1007/s 00415 -020-10285-9）包含补充材料，可供授权用户使用。
To perform an updated review of the literature on the neurological manifestations of COVID-19-infected patients A PRISMA-guideline-based systematic review was conducted on PubMed, EMBASE, and SCOPUS. Series reporting neurological manifestations of COVID-19 patients were studied. 39 studies and 68,361 laboratory-confirmed COVID-19 patients were included. Up to 21.3% of COVID-19 patients presented neurological symptoms. Headache (5.4%), skeletal muscle injury (5.1%), psychiatric disorders (4.6%), impaired consciousness (2.8%), gustatory/olfactory dysfunction (2.3%), acute cerebrovascular events (1.4%), and dizziness (1.3%), were the most frequently reported neurological manifestations. Ischemic stroke occurred among 1.3% of COVID-19 patients. Other less common neurological manifestations were cranial nerve impairment (0.6%), nerve root and plexus disorders (0.4%), epilepsy (0.7%), and hemorrhagic stroke (0.15%). Impaired consciousness and acute cerebrovascular events were reported in 14% and 4% of patients with a severe disease, respectively, and they were significantly higher compared to non-severe patients (p < 0.05). Individual patient data from 129 COVID-19 patients with acute ischemic stroke (AIS) were extracted: mean age was 64.4 (SD ± 6.2), 78.5% had anterior circulation occlusions, the mean NIHSS was 15 (SD ± 7), and the intra-hospital mortality rate was 22.8%. Admission to the intensive care unit (ICU) was required among 63% of patients. This updated review of literature, shows that headache, skeletal muscle injury, psychiatric disorders, impaired consciousness, and gustatory/olfactory dysfunction were the most common neurological symptoms of COVID-19 patients. Impaired consciousness and acute cerebrovascular events were significantly higher among patients with a severe infection. AIS patients required ICU admission in 63% of cases, while intra-hospital mortality rate was close to 23%. The online version of this article (10.1007/s00415-020-10285-9) contains supplementary material, which is available to authorized users.
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